[Clinical reevaluation of continuous intravenous infusion of 5-fluorouracil--plasma concentrations and clinical dose by continuous intravenous and 60-min infusions].
Daily and intermittent continuous intravenous infusions [by gravity drip, (IVG) or infusion pump, (IVP)] and intermittent short-time intravenous drip infusion of 5-FU were carried out on advanced cancer patients. The MTD and dose-limiting toxicity were investigated in relation to the plasma concentrations of 5-FU determined by HPLC. Responses in eleven patients receiving IVG administration daily at 8-21 mg/kg/day were NC, but those given 5-FU alone showed no adverse reactions. Plasma concentrations were too low to be determined. In 9 patients receiving IVG or IVP administration weekly at 60 mg/kg for 24 hr, 1 of the 5 evaluable patients showed reduced hepatic metastatic lesions. One of 4 patients receiving IVP administration weekly at 120 mg/kg for 48 hr showed a disappearance of metastatic lesions in the skeletal muscle, but bone marrow suppression was observed as dose-limiting toxicity. Pharmacokinetics were more stable in IVP than in IVG with less individual difference in the plasma concentrations. Among the outpatients receiving short-time iv, IVG administration once or twice a week, 2 patients given weekly administrations at 20 mg/kg for 60 min showed slight adverse reactions. In 6 patients given high-dose administrations, bone marrow suppression was observed. When pharmacokinetics in the patients given 5-FU for 60 min were compared between the IVG and IVP groups, there were individual differences in plasma concentrations, but the differences were not significant. It was concluded from above results that the following practical dose schedules would be recommendable: 60 mg/kg for 24hr/week by IVP for inpatients and 20 mg/kg for 60 min/week by IVG for outpatients.
Nakatsu
T
T
Dept. of Surgery Kawasaki Municipal Hospital.
Yokoyama
I
I
Tsuyuki
K
K
Soh
Y
Y
Hanai
G
G
Matsumoto
H
H
Kubo
H
H
Matsumoto
K
K
Nohga
K
K
Koyanagi
H
H
D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005069:Evaluation Studies as Topic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007260:Infusion Pumps / Q000592:standards*; D007262:Infusions, Intravenous / Q000592:standards; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012004:Rectal Neoplasms / Q000097:blood / Q000188:drug therapy; D012186:Retroperitoneal Neoplasms / Q000097:blood / Q000188:drug therapy; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy*
D005472:Fluorouracil